Individual provider Active NPI

Emily Ornelas, DC

  • Chiropractor
  • Crystal Lake, IL
National Provider Identifier
1457670259
Registry record updated May 19, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
038011691 Issued in IL
Practice address
318 Memorial Dr
Suite 200
Crystal Lake, IL 60014-6267
Phone
(815) 455-1910
Fax
(815) 455-2541
NPI assigned
May 19, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 19, 2019

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 038011691 IL Primary

Addresses

Primary practice location

318 Memorial Dr
Suite 200
Crystal Lake, IL 60014-6267

Mailing address

650 E Terra Cotta Ave
Ste 103
Crystal Lake, IL 60014-3654
Phone (815) 455-1910

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170216002767 IL Practitioner - Chiropractic 4183802630 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
National College of Chiropractic, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

650 E Terra Cotta Ave
Suite 103
Crystal Lake, IL 60014-3654
Phone (630) 965-7225

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
038011691ILMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Alternative and Complementary Therapies for Wellness, LTD Chiropractor CurrentSince Apr 28, 2010 Accepting new patients

Locations

650 E Terra Cotta Ave
Ste 103
Crystal Lake, IL 60014
Phone (630) 965-7225

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1274227200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1558224000000",
    "number": "1457670259",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "650 E TERRA COTTA AVE",
            "address_2": "STE 103",
            "city": "CRYSTAL LAKE",
            "state": "IL",
            "postal_code": "600143654",
            "telephone_number": "815-455-1910",
            "fax_number": "815-455-2541"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "318 MEMORIAL DR",
            "address_2": "SUITE 200",
            "city": "CRYSTAL LAKE",
            "state": "IL",
            "postal_code": "600146267",
            "telephone_number": "815-455-1910",
            "fax_number": "815-455-2541"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ORNELAS",
        "first_name": "EMILY",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-05-19",
        "last_updated": "2019-05-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "IL",
            "license": "038011691",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Crystal Lake, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 19, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.